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Juan Luis Cordova
Driver in El Centro, California
NPI 1043704034

Juan Luis Cordova is a Driver based in El Centro, CA. Juan Luis Cordova practices in El Centro, CA. The NPI Number for Juan Luis Cordova is 1043704034 and holds a License No. F4704795 (California).

The current practice location address for Juan Luis Cordova is 1480 S Imperial Ave, El Centro, CA and can be reached out via phone at 760-455-1706.

Location: 1480 S Imperial Ave, El Centro, CA, 92243-4200
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1043704034
Provider Name
Juan Luis Cordova
Credential
Provider Entity Type
Individual
Gender
Male
Address
1480 S Imperial Ave, El Centro, CA, 92243-4200
Phone Number
760-455-1706
Fax Number
Provider Enumeration Date
06/21/2018
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
F4704795 01 CA CALIFORNIA ID
institution
Provider Business Practice Location Address Details
Address
1480 S Imperial Ave
City
El Centro
State
California
Zip
92243-4200
Phone Number
760-455-1706
Fax Number
person
Provider Business Mailing Address Details
Address
1480 S Imperial Ave
City
El Centro
State
California
Zip
92243-4200
Phone Number
760-455-1706
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Driver
Speciality
-
Taxonomy
172A00000X
License No.
F4704795 (California)
Definition
A person employed to operate a motor vehicle as a carrier of persons or property.
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